Provider Demographics
NPI:1124814587
Name:RIPPLE THERAPY & WELLNESS, PLLC
Entity type:Organization
Organization Name:RIPPLE THERAPY & WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:808-594-9934
Mailing Address - Street 1:401 W JOHN ST
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-5840
Mailing Address - Country:US
Mailing Address - Phone:808-594-9934
Mailing Address - Fax:
Practice Address - Street 1:401 W JOHN ST
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-5840
Practice Address - Country:US
Practice Address - Phone:808-594-9934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty